Clinical Scorecard: Orthokeratology Today: Using Biometry to Guide Ortho-k Decisions

At a Glance

Key Highlights

• Stable refraction does not always indicate stable myopia.
• Axial length growth is a critical measure for evaluating myopia progression.
• Successful interventions can reduce axial elongation to 0.10-0.15 mm/year.
• Follow-up visits should be scheduled consistently to account for variations.
• A growth chart can help communicate treatment effectiveness.

Guideline-Based Recommendations

Diagnosis

• Monitor axial length to assess myopia progression.

Management

• Adjust treatment plans based on sustained trends in axial length measurements.

Monitoring & Follow-up

• Schedule follow-ups at the same time of day to ensure consistency.

Risks

• Untreated myopia can lead to significant axial elongation.

Patient & Prescribing Data

Children experiencing myopia progression.

Consider dual therapy with low-dose atropine if axial elongation is noted.

Clinical Best Practices

• Use a laminated chart with normative data for axial length growth.
• Align measurements with clinical milestones and lifestyle changes.
• Do not overreact to single axial length readings; look for trends.

References

• Atchison et al, 2004
• Tideman et al, 2018
• Cho and Cheung, 2012
• Walline et al, 2020